Milestones :: Perspectives

Measles no longer endemic in 79% of the WHO European Region
Copenhagen, 26 September 2017
In the WHO European Region, 42 of 53 countries have interrupted endemic transmission of measles, and 37 countries have interrupted endemic transmission of rubella as of the end of 2016. This was determined by the European Regional Verification Commission for Measles and Rubella Elimination (RVC) at its 6th meeting in June 2017.
“I congratulate each country for fulfilling the commitment to protect its people from measles and rubella and collectively moving the European Region closer to its elimination goal,” said Dr Zsuzsanna Jakab, WHO Regional Director for Europe. “However, we cannot become complacent now. Outbreaks continue to cause unnecessary suffering and loss of life, and routine immunization coverage is decreasing. It is unacceptable that 1 in every 15 children still does not receive the first vaccination dose against measles and rubella on time. We will eliminate these diseases from our Region, but need to be ready to walk the hardest last mile.”…:::::: ::::::Serum Institute’s vaccine demonstrates significant efficacy against severe rotavirus gastroenteritisIndian Government orders the vaccine for use in Universal Immunization Programme
Pune, India (26 September 2017)—Results from a Phase 3 efficacy study in India of the Serum Institute of India Pvt. Ltd.’s rotavirus vaccine BRV-PV (known as ROTASIIL®) were published in the journal Vaccine. The study showed the vaccine to be safe, well tolerated, and to provide significant efficacy against severe rotavirus gastroenteritis. In 2013, an estimated 47,100 rotavirus deaths occurred in India, 22 percent of all rotavirus deaths that occurred globally.

ROTASIIL reduced severe rotavirus diarrhea by more than a third – 39.5 percent over two years. Significantly, the vaccine efficacy was nearly 55 percent against the most severe and potentially life-threatening cases of rotavirus diarrhea, which represent the highest risk of dehydration, hospitalizations, and deaths. The results demonstrated by ROTASIIL in India appear generally comparable to the performance of RotaTeq® and Rotarix® in Bangladesh and in some African countries.

Dr. Rajeev Dhere, executive director of the Serum Institute, under whose leadership this vaccine has been developed, commented, “We are delighted with these results, which indicate that ROTASIIL could save the lives of tens of thousands of children each year in India and, potentially, around the world.”

The international nonprofit PATH partnered with Serum Institute on evaluating this vaccine in the Phase 3 efficacy study. Six study sites across India enrolled 7,500 infants in the trial. ROTASIIL is an oral vaccine administered to infants in a three-dose course at 6, 10, and 14 weeks of age, at the same time as routine vaccinations under India’s Universal Immunization Programme.

The office of the Drugs Controller General of India, through its subject expert committee, reviewed the Phase 3 safety and efficacy results and subsequently inspected Serum Institute’s manufacturing facilities leading to licensure of ROTASIIL in January 2017.

The Government of India has placed an order for 3.8 million doses of ROTASIIL to use in the Universal Immunization Programme, which serves 26 million children. Serum Institute has manufactured the vaccine doses and is awaiting instructions from the Ministry of Health and Family Welfare for their distribution. ROTASIIL will also be available for sale in India’s private market later this year.

Serum Institute is pursuing World Health Organization (WHO) prequalification to make this vaccine available for global procurement. PATH and Serum Institute partnered to conduct a separate Phase 3 study in India to gather additional data required for WHO prequalification; results from that study will be submitted for publication this year.

“This is great news for India,” noted Dr. David Kaslow, PATH’s vice president for Essential Medicines and global head of the Center for Vaccine Innovation and Access. “The results and successful licensure of this rotavirus vaccine is an exciting and encouraging milestone toward the public health goal of improving the supply of affordable rotavirus vaccines, both in India and worldwide.”

Médecins Sans Frontières and Epicentre are also evaluating the efficacy and safety of ROTASIIL in a separate Phase 3 study in Niger. That study is still ongoing, but results from the primary analysis (one year of data) also showed the vaccine to be highly efficacious for the prevention of severe rotavirus diarrhea and to have an excellent safety profile. The efficacy of the vaccine against severe and very severe rotavirus diarrhea in the Niger study was 66.7 percent and 78.8 percent, respectively. These results were published in the New England Journal of Medicine in March 2017.

The ROTASIIL used in the Niger study was stored at less than 25°C and transported for vaccination at ambient temperature, thus bypassing the typically challenging and costly cold-chain requirements that apply to most other vaccines. The ROTASIIL used in the India study was from the same lots of vaccine used in the Niger study.

:::::: ::::::Towards a Rabies-Free World as Unparalleled Global Initiative Gets UnderwayGlobal partners announce plan to end human deaths from dog-transmitted rabies by 2030
NEW YORK, Sept. 28, 2017 /PRNewswire/
…World Rabies Day marks the announcement of the biggest global anti-rabies initiative, as the World Health Organization (WHO), the World Organisation for Animal Health (OIE), the Food and Agriculture Organization of the UN (FAO) and the Global Alliance for Rabies Control (GARC) reveal an ambitious plan to end human deaths from dog-transmitted rabies by 2030.

The plan — ‘Zero by 30: The Strategic Plan’ — centres on a One Health approach and addresses the disease in a holistic and cross-sectoral manner while highlighting the important role veterinary, health and educational services play in rabies prevention and control.

“The plan ensures support to countries in developing national plans, and provides innovative training and education tools across regional rabies networks,” said Dr. Bernadette Abela-Ridder on behalf of the four partners. “Vaccines are a key component of the global plan and a trigger for national programmes. The United Against Rabies collaboration provides leadership and advocates for resources critical to reaching zero human rabies deaths by 2030.”

‘United against Rabies’ builds on more than ten years of global partnership, research and evidence- building to demonstrate the feasibility of eliminating dog-transmitted rabies. The plan places a magnifying glass on the problem of continued human deaths from rabies and helps to make this a priority disease for key international organizations and governments…:::::: ::::::New global initiative will connect the world for better health through digital technologyDigital Square, led by PATH, will align multi-sector investments into scalable solutions that strengthen national digital health systems
Washington, DC, September 28, 2017—Global Innovation Week, an annual gathering of the international development community, kicked off today with a series of institutional commitments to support innovation. This evening at USAID, Dr. David Fleming, PATH’s vice president for Public Health, delivered PATH’s pledge to advance a new type of funding model that maximizes the impact of every dollar spent on digital technology in the global health sector.

“For over a decade, PATH’s Digital Health program has been a leader in the application and use of scalable digital products and services globally and at the country level. We build on that legacy by pledging to encourage co-investment among partners and donors to support countries in seamlessly connecting their digital health systems, sharing better data, and reaching better health outcomes,” said Dr. Fleming.

As a part of this commitment, PATH is pleased to announce Digital Square. The new initiative, comprised of 40+ partner organizations, encourages more efficient investment in digital health technology solutions in low- and middle-income countries through an innovative co-investment model. “Co-investment is a simple but powerful concept. Development dollars are scarce; by coordinating them, we can maximize the impact of our financial investments,” said Dykki Settle, Director of Digital Health at PATH.

The initiative offers a platform for individuals and organizations to confidently coordinate their funding and technical expertise into a suite of proven, adaptable digital health technologies. These solutions can be scaled across an entire country, and even between countries. “This alignment of donors and partners to fund proven technology solutions – that we know can scale – is what sets us apart,” said Digital Square Director Lesley-Anne Long.

Digital Square also helps to support countries to develop the skills they need at all levels—from national government leaders to local healthcare workers—to bring these technologies to scale. Digital Square is a USAID program designed and funded in partnership with the Bill & Melinda Gates Foundation.

::::::::::::CholeraYemeneDEWS Cholera Response Daily Epidemiological Update [EN/AR] 29 Sep 2017
Suspected Cases: 753,098
Associated Deaths: 2,122
Case Fatality Rate 0.28%
Governates affected: 96%
Districts affected: 91%:::::: 900,000 vaccines ‘en route’ to Cox’s Bazar to prevent choleraOral cholera vaccine will protect Rohingya refugees seeking shelter in Bangladesh as well as the resident population
Cox’s Bazar, Bangladesh, 29 September 2017 – The International Coordinating Group (ICG) on Vaccine Provision will release 900,000 doses of the Oral Cholera Vaccine (OCV) from the global stockpile to prevent the spread of cholera among recently arrived vulnerable populations and host communities in areas around Cox’s Bazar.
The Government of Bangladesh made the request to the ICG on 27 September, and the approval was granted in 24 hours by the coordinating mechanism that brings together WHO, UNICEF, Médecins Sans Frontières (MSF), and the International Federation of the Red Cross (IFRC).
ICG partners – with support from Gavi, the Vaccine Alliance – will deliver 900,000 doses of Oral Cholera Vaccine to Bangladesh within two weeks for an immunisation campaign due to start in October.
“This is a precautionary step to avoid a preventable cholera outbreak,” said Dr. Abul Kalam Azad, Director General of Health Services at the Bangladesh Ministry of Health and Family Welfare. “We appreciate the support and speed of partners in delivering on this urgent request, and we look forward to receiving and using the vaccines.”
More than half a million people have crossed from Myanmar to Bangladesh since 25 August following violence in Rakhine State.
Many are crowded into camps or temporary settlements with challenging access to clean water and sanitation amid heavy rains; this increases the risk of vector and waterborne diseases such as cholera.
“We are doing everything we can to prevent an outbreak, including pre-positioning supplies, implementing disease surveillance and monitoring water quality,” said Dr. Navaratnasamy Paranietharan, WHO Representative in Bangladesh. “A vaccination campaign will help to keep this vulnerable population safe from cholera.”